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Is the keto diet a safe option for losing weight?

Canada-wide Keto Diet Survey
WATCH: Dalhousie University's Agri-Food Analytics Lab, led by scientific director Sylvain Charlebois, has just released the results of a new Canada-wide survey that focuses on why Canadians follow the keto diet and why some have given up on it.

This is part of Canadian Health and Wellness, a series in which Corus radio stations nationwide dig into health issues facing Canadians with the help of some of today’s most respected diet and exercise practitioners. Read the rest of the series here.

By 2023, an additional 1.7 million Canadians will be obese, according to a 2017 study from the Organization of Economic Co-operation and Development (OECD). The report estimates 25 per cent of the population is currently obese — that’s about 9.35 million people.

With just three years until the OECD milestone, people are attempting to fight the battle of the waistline bulge, and many are exploring the keto diet as an option to lose weight.

A ketogenic diet is rich in proteins and fats, and it usually includes plenty of meats, eggs, sausages, cheeses, fish, nuts, butter, oils, seeds and fibrous vegetables.

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The keto diet forces the body to burn ketones from fat instead of glucose from carbohydrates, and during that transition, a person’s body can experience something called the keto flu. As the name suggests, it leads to symptoms like nausea, vomiting, headaches, constipation, diarrhea and irritability, among others.

LISTEN BELOW: Canadian Health and Wellness — the keto diet

Tammy Crowley of Welland, Ont., is one of them.

Tammy Crowley/Facebook
Tammy Crowley/Facebook Tammy Crowley/Facebook

She’s been following the ketogenic diet for two years.

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Crowley says she has lost 35 pounds and kept it off. Over the years, she’s tried everything from diet programs to more drastic measures.

“I don’t want to specifically say any one program,” Crowley says. “Everyone is different, and whatever works for you is great. I just found something that finally worked for me. I’ve actually, through the years, I’ve had gastric bypass (surgery) for losing weight, and yes, that was great in the beginning, but you put it back on.

“It’s not an easy fix. Unless you learn properly what’s good for you, that’s the best way to go,” Crowley continues. “I’m not running any of the other programs down. This just works for me. I’ve never felt better. I’m going to be 60 soon and I have more energy now that when I was in my 20s.”

Ins and outs of the keto diet
Ins and outs of the keto diet

The effectiveness of the keto diet as part of a long-term lifestyle change is still unknown, but there are medical uses for the regimen. For example, the keto diet is being used to help treat children with epilepsy.

Jennifer Fabe, a registered nutritionist with the Division of Pediatric Neurology at McMaster Children’s Hospital, says the therapeutic ketogenic diet has been used as a treatment for epilepsy for nearly a century.

READ MORE: Super Awesome Science Show recap — What going keto can do for you

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However, she stresses, it is customized for each patient and only used when people meet certain medical criteria. Fabe says the diet is monitored regularly for effectiveness, tolerance and side effects at home and by a medical team.

Fabe is also the president of Matthew’s Friends, a charity that specializes in ketogenic dietary therapies for children and adults with drug-resistant epilepsy.

Dr. Andrew Mente, an epidemiologist with the Population Health Research Institute at McMaster University in Hamilton, Ont., says the keto diet can also have benefits for those with Type 2 diabetes.

Dr. Andrew Mente, an epidemiologist with the Population Health Research Institute at McMaster University in Hamilton, Ont.
Dr. Andrew Mente, an epidemiologist with the Population Health Research Institute at McMaster University in Hamilton, Ont. Andrew Mente/ McMaster University

“Conceptually, it is a diet that is high in fat, adequate in protein and very low in carbohydrates,” Mente explains. “And conceptually, this diet would make sense for people with carbohydrate intolerance, i.e. people with Type 2 diabetes, in controlling their glucose levels and possibly even reversing their diabetes.”

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“There is evidence that when people are assigned to a ketogenic diet if they have Type 2 diabetes, they are able to normalize their glucose levels and possibly reverse diabetes,” he adds. “In people from general populations, generally healthy populations without diabetes, the evidence is less clear. So, what we would need going forward is more study to investigate both the effectiveness and safety of a ketogenic diet in general populations.”

Canada-wide Keto Diet Survey
Canada-wide Keto Diet Survey

Mente says the” ketogenic diet is one approach for Type 2 diabetes, but it’s not the only diet for people with Type 2 diabetes. It’s too soon to say what the long-term impacts of the diet will be on both those with Type 2 diabetes and the general population.”

According to Mente, the best idea for those without medical issues requiring a ketogenic diet is to eat a balanced diet.

READ MORE: The keto diet was ranked one of the worst diets for 2020, so why is it still popular?

“A nuanced approached is seldomly promoted. Everybody seems to take an extreme position on a variety of matters, and diet is no different,” Mente says. “For general populations, I would say a nuanced approach is more appropriate going forward until we get the evidence (on the long-term impact of keto) because we want to make recommendations that are evidenced-based.”

But what about using the keto diet for weight loss?

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Dan Tisi, registered dietitian at St. Joseph’s Health Care in Hamilton, says there are some pros and cons to losing weight with the keto diet. If there’s a medical indication there are some benefits, like epilepsy, then the keto diet can have a positive impact. However, for weight loss, Tisi views it as another tool in the toolbox.

“With ketogenics having an emphasis on certain fats and proteins, people need to be aware of the nutrition that may be missing if they are on keto,” Tisi says.

Alcoholic Drinks You Can Have On The Keto Diet
Alcoholic Drinks You Can Have On The Keto Diet

“A lot of people will have to do supplementation of some kind with higher-quality supplements because there tends to be a B vitamin deficiency. Electrolytes are the most common thing that’s missing, usually.

“They are also responsible for things like the keto flu that people experience in the beginning, especially the electrolytes part, and magnesium has to be added to that as well. Although, most North Americans are already deficient in magnesium,” Tisi explains.

“It’s best if you are going ahead with keto to do it with the assistance of someone that can really assess your situation and help you determine if this is the tool you should be reaching for.”

READ MORE: You can stick to a keto diet during the holidays. But is it worth it?

For someone like Crowley, who has struggled with weight issues for most of her life, she is not willing to easily let go of something that has worked.

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She says she is aware that some cardiologists have concerns about keto’s emphasis on full fat and high protein, and so does she. Crowley’s father died at 51 from a heart attack, and she says that plays on her mind. She says she did a lot of research before starting keto, and Crowley is willing to shoulder the medical risk.

“I’d rather feel as good as I feel right now and only live another five years than live another 10 years and feel like crap.”